Discover and read the best of Twitter Threads about #dolo650

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1) I'm no expert but the Dolo 650 controversy is either a meaningless or a malignant one.

PCM is an OTC drug --> it is almost never the only drug in a prescription.

Why?
2) PCM doesn't provide any significant analgesia unless you are taking 2-3 gm/day.

Its good for the myalgia and arthralgia of febrile illnesses especially if NSAIDs are contraindicated --> like dengue which has a risk of thrombocytopenia.
3) For everything beyond this, you will need an adequate dose of an NSAID +/- local or systemic glucocorticoid therapy --> even DMARDs if its rheumatological!

Most patients in India don't go to a doctor for mild aches and pains --> they will buy PCM directly!
Read 10 tweets
1) A brief review of paracetamol aka PCM

Synthesized by HN Morse at John Hopkins at 1977 --> a derivative of acetanilide and phenacetin.

It has become a common household drug since the 1980s as phenacetin use dropped --> concerns of analgesic nephropathy.
2) It is best known as acetaminophen aka Tylenol in the Western hemisphere.

PCM provides good antipyresis and analgesia --> but anti inflammatory action is minimal.
3) PCM is basically an NSAID that blocks COX1 and COX2 enzymes --> at the peroxide site (distinct among NSAID).

But inflammation raises local peroxide levels --> counters PCM action.

So PCM is a great antipyretic and analgesic but poor anti inflammatory.
Read 10 tweets

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